Liver & Gastroenterology

AIMS65 Score Calculator – Upper GI Bleeding Mortality Risk

Clinical calculation support · Verify results before clinical use

AIMS65 Calculator

Enter the patient's admission findings to calculate the score.

0Score / 5

Albumin

Serum albumin concentration at initial evaluation.

1 point if <3.0 g/dL

Serum albumin (g/dL)

If your laboratory reports g/L, divide the value by 10 before entry.

International Normalized Ratio (INR)

Use the INR measured at initial evaluation.

1 point if >1.5

INR

Altered Mental Status

Clinically documented altered mental status (e.g. disorientation, stupor, or coma).

1 point if present

Mental status

Systolic Blood Pressure

Systolic blood pressure at initial evaluation.

1 point if ≤90 mmHg

Systolic BP (mmHg)

Age

Age in completed years at presentation.

1 point if >65 years

Age (years)

—AIMS65

In-hospital mortality risk signal

Complete all fields

The score will be calculated when all five variables are entered.

Clinical interpretation Enter admission data for all five AIMS65 variables. Each criterion contributes one point.

AIMS65 estimates in-hospital mortality risk; it is not a stand-alone disposition or treatment rule.

About the AIMS65 Score

AIMS65 is a pre-endoscopic risk score developed to predict in-hospital mortality, length of stay, and cost among patients admitted with acute upper gastrointestinal bleeding (UGIB).

One point is assigned for each of five admission variables: low albumin, elevated INR, altered mental status, low systolic blood pressure, and age older than 65 years. The total score ranges from 0 to 5.

Variables and Scoring

Variable	Criterion	Points
Albumin	<3.0 g/dL	1
INR	>1.5	1
Mental status	Altered mental status	1
Systolic BP	≤90 mmHg	1
Age	>65 years	1

Interpretation and Evidence

The original development study reported in-hospital mortality of 0.3% among patients with an AIMS65 score of 0 and 31.8% among patients with a score of 5. Mortality increased with increasing score in the derivation and validation cohorts.

An external single-centre cohort reported higher in-hospital mortality for scores ≥2 than for scores 0–1. This threshold is a risk-stratification signal from that cohort, not a universally calibrated mortality percentage or a discharge criterion.

Clinical use: Use AIMS65 as an adjunct to clinical assessment. It does not replace hemodynamic assessment, resuscitation, endoscopic evaluation, or a validated score intended to identify very-low-risk patients for outpatient management.

References

Saltzman JR, Tabak YP, Hyett BH, Sun X, Travis AC, Johannes RS. A simple risk score accurately predicts in-hospital mortality, length of stay, and cost in acute upper GI bleeding. Gastrointest Endosc. 2011;74(6):1215–1224. doi:10.1016/j.gie.2011.06.024

Thandassery RB, Sharma M, John AK, et al. Clinical Application of AIMS65 Scores to Predict Outcomes in Patients with Upper Gastrointestinal Hemorrhage. Clin Endosc. 2015;48(5):380–384. doi:10.5946/ce.2015.48.5.380

Laine L, Barkun AN, Saltzman JR, Martel M, Leontiadis GI. ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding. Am J Gastroenterol. 2021;116(5):899–917. doi:10.14309/ajg.0000000000001245

Clinical disclaimer: This calculator is intended for healthcare professionals and educational use. AIMS65 is a prognostic score, not a substitute for clinical judgement or guideline-directed care. The score predicts in-hospital mortality at a population level; individual outcomes may differ. Do not use AIMS65 alone to determine discharge, level of care, transfusion, endoscopy timing, or treatment.